There are reasons to be both optimistic and cautious about Centene Corporation (NYSE:CNC). Despite a recent decline in share value compared to the S&P 500, the company's financial performance and industry position are subjects of debate among investors.

Centene's revenue growth has been impressive, with a 16.9% annual growth rate over the past five years, outperforming many competitors in the healthcare industry. This growth momentum reflects the company's strong appeal to its customer base, consisting of low-income and high-needs populations under government healthcare programs.

Additionally, Centene benefits from economies of scale due to its significant revenue of $163.1 billion in the last 12 months. This advantage allows the company to negotiate favorable terms with suppliers and maintain a competitive edge in the market.

However, a cause for concern lies in Centene's customer growth, which has been slower than desired over the past two years. With a 3.6% average annual growth rate in customer numbers, Centene faces challenges in expanding its client base amidst growing competition in the industry.

In conclusion, while Centene shows promise with its strong revenue growth and market position, investors should also consider the muted customer expansion as a potential risk factor. With the stock currently priced at 8.5× forward price-to-earnings, it's advisable to conduct thorough research before making investment decisions.